Claim Audit Quality Specialist

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

laim Audit Quality Analysts need to have a wide depth and breadth of knowledge of several different areas within Meritain.

The role requires a high level of detail and review.

A candidate must become subject matter experts in claims, plan documents, eligibility, coverages, and quirks of multiple groups.

Knowledge in all these areas is imperative to be an effective auditor.

The QA analyst must be able to effectively manage their time and work in a high production environment, while maintaining high quality standards.

Required Qualifications

• 1 plus years of Healthcare Insurance Claims experience
• Experience with Microsoft Office Suite (Excel, Word, One Note, and Outlook)

Preferred Qualifications

• 1 plus years of DG
• Knowledge of CPT and diagnosis codes
• Attention to detail
• Time management skills
• Ability to manage competing priorities

Education

High School Diploma or equivalent GED

Pay Range

The typical pay range for this role is :

$17.00 - $28.45

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.